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General NPI Number Information
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NPI Number | 1497166052
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Entity Type | Organization
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Legal Business Name | GRAYS TRANSPORTATION LLC
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Dates
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Enumeration Date | 05/16/2014
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Last Update Date | 05/16/2014
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Provider Practice Location Address
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Address Line | 3639 KAELYN WAY
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City | INDIANAPOLIS
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State | IN
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Zip | 46228-7230
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Country | US
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Telephone | 317-250-5494
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Fax |
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Provider Business Mailing Address
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Address Line | 3639 KATELYN WAY
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City | INDIANAPOLIS
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State | IN
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Zip | 46228-7230
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SHANELLE ROBERTS
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Credential |
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Telephone | 317-250-5494
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3416L0300X
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Taxonomy Name | Land Ambulance
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License Number |
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License Number State | IN
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